急性肠系膜上动脉血栓形成的螺旋CT诊断

目的:分析急性肠系膜上动脉血栓形成的临床特点及螺旋CT表现,提高认识水平.方法:回顾性分析7例经手术证实为肠系膜上动脉血栓形成的螺旋CT表现.7例均行平扫加增强扫描,及最大密度投影图像后处理重建.结果:7例增强均显示肠系膜上动脉血栓形成的直接征象为肠系膜上动脉管腔充盈缺损.螺旋CT平扫5例出现肠系膜上动脉密度增高,4例肠系膜上静脉与肠系膜上动脉管径比例<1,4例肠系膜上动脉壁斑片状钙化,2例肠腔淤积扩张,2例薄纸样肠壁及腹腔积液等征象.7例最大密度投影重建显示肠系膜上动脉血管内不同程度充盈缺损、管腔狭窄.结论:螺旋CT检查对于早期诊断肠系膜上动脉血栓形成是一种有价值的方法.对于不明原因所致腹痛及临床怀疑肠系膜缺血的患者均应及时行螺旋CT检查.

Diagnosis of Acute Superior Mesenteric Artery Thrombosis with Spiral CT

Objective:To study the clinical and CT features of acute superior mesenteric artery thrombosis(ASMAT)so as to improve the diagnostic knowledge of ASMAT.Methods:The clinical and CT materials of seven patients with surgically confirmed acute superior mesenteric artery thrombosis were retrospectively reviewed and studied.Plain and contrast enhanced abdominal CT as well as image reconstruction using maximum intensity projection(MIP)technique were performed in all cases.Results:On contrast enhanced CT scans,direct sign of ASMAT which showed filling defect within the lumen of the involved superior mesenteric artery was detected in all the 7 cases.On plain scans,CT density of the SMA was found increased in 5 cases and the ratio of the lumen diameter of SMV with that of the SMA(SMV/SMA)was measured as less than 1(<1)in 4 cases.Calcified plaques on the walls of SMA in 4 cases,dilated and accumulated intestinal lumens in 2 cases and expanded intestines with paper-like thin walls as well as ascites in 2 cases were respectively detected.On the images reconstructed with MIP technique,considerable extents of filling defects and narrowing of the involved SMA lumens were revealed in all the 7 cases.Conclusion:Spiral CT was one of the helpful and effective imaging modalities for the early diagnosis of acute superior mesenteric artery thrombosis.Therefore,in patients with acute abdominal pain of unknown causes and those patients of whom disorders of mesenteric ischemia were clinically suspected,abdominal SCT examination should be highly recommended as early as possible.